WO2024243646A1 - Apparatus for use in tissue repair - Google Patents
Apparatus for use in tissue repair Download PDFInfo
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- WO2024243646A1 WO2024243646A1 PCT/AU2024/050581 AU2024050581W WO2024243646A1 WO 2024243646 A1 WO2024243646 A1 WO 2024243646A1 AU 2024050581 W AU2024050581 W AU 2024050581W WO 2024243646 A1 WO2024243646 A1 WO 2024243646A1
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/3604—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix characterised by the human or animal origin of the biological material, e.g. hair, fascia, fish scales, silk, shellac, pericardium, pleura, renal tissue, amniotic membrane, parenchymal tissue, fetal tissue, muscle tissue, fat tissue, enamel
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools for implanting artificial joints
- A61F2/4601—Special tools for implanting artificial joints for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools for implanting artificial joints
- A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4618—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof of cartilage
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools for implanting artificial joints
- A61F2/4644—Preparation of bone graft, bone plugs or bone dowels, e.g. grinding or milling bone material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
- A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
- A61K35/35—Fat tissue; Adipocytes; Stromal cells; Connective tissues
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/14—Macromolecular materials
- A61L27/20—Polysaccharides
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/14—Macromolecular materials
- A61L27/22—Polypeptides or derivatives thereof, e.g. degradation products
- A61L27/222—Gelatin
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/3641—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix characterised by the site of application in the body
- A61L27/3645—Connective tissue
- A61L27/3654—Cartilage, e.g. meniscus
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L27/52—Hydrogels or hydrocolloids
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P19/00—Drugs for skeletal disorders
- A61P19/04—Drugs for skeletal disorders for non-specific disorders of the connective tissue
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30756—Cartilage endoprostheses
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/28—Bones
- A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30756—Cartilage endoprostheses
- A61F2002/30762—Means for culturing cartilage
Definitions
- the present disclosure relates to preparation of a composition for repair or regeneration of tissue. It relates particularly, but not exclusively, to apparatuses, kits, systems and methods for preparation of a composition for repair or regeneration of cartilage, and treatment of a cartilage defect using said composition.
- Background of Invention Articular (hyaline) cartilage is specialised tissue that lines the surface of long bones and is critical for normal joint function. Human cartilage has a poor ability to self- repair, meaning small defects after injury tend to enlarge or deteriorate over time. The degeneration of cartilage leads to osteoarthritis, a painful and debilitating condition which is a major contributor to the global burden of disease.
- Known interventions include: microfracture in which small holes are punched through to underlying bone beneath the defect site in order to recruit regenerative stem cells from the bone marrow, mosaicplasty in which healthy cartilage is harvested from non-load- bearing regions of the joint and used to inlay the defect area, autologous chondrocyte implantation (ACI) in which patient chondrocytes are expanded in the lab and then reimplanted without a matrix, and matrix-assisted autologous chondrocyte implantation (MACI) in which patient chondrocytes are expanded in the laboratory and then reimplanted within a collagen matrix.
- ACI autologous chondrocyte implantation
- MCI matrix-assisted autologous chondrocyte implantation
- the present disclosure provides an apparatus for preparation of a composition for treatment or repair or regeneration of tissue, the apparatus comprising: a collection vessel configured to receive harvested tissue; and at least one filter element located inside the collection vessel to separate a cellular fraction (e.g., a Stromal Vascular Fraction (SVF)) or a cellular extract from the harvested tissue within the collection vessel; wherein the apparatus is configured to: receive a volume of a polymer composition for mixing with the cellular fraction (e.g., SVF) or cellular extract obtained from the harvested tissue; and provide a prepared composition comprising a mixture of the cellular fraction (e.g., SVF) or cellular extract and the polymer composition for treatment or repair or regeneration of the tissue.
- a cellular fraction e.g., a Stromal Vascular Fraction (SVF)
- SVF Stromal Vascular Fraction
- the apparatus comprises a delivery vessel, couplable with the collection vessel, for containing the prepared composition which is to be delivered to the site of defect or injury.
- at least one of the collection vessel and the delivery vessel is pre-loaded with a volume of the polymer composition.
- the pre- loaded polymer composition is in a solid or gel state and the pre-loaded collection vessel and/or delivery vessel is able to receive a solid to liquid phase change agent for liquefying the polymer.
- the solid to liquid phase change agent may comprise, for example, a thermal mechanism or a chemical agent.
- At least one of the collection vessel and the delivery vessel is configured to receive a volume of liquid polymer composition before mixing with the cellular fraction (e.g., SVF) or cellular extract.
- the at least one filter element comprises a plurality of openings of about 30 to 60 um, preferably about 40 ⁇ m.
- the apparatus may comprise a valve for coupling between the collection vessel and a delivery vessel.
- the at least one filter element comprises at least one strainer attached to an interior wall of the collection vessel.
- the filter element comprises a hollow filter barrel configured to be received within the collection vessel, and to receive the harvested tissue therein, the filter barrel comprising at least one strainer configured for separation of the cellular fraction (e.g., SVF) or cellular extract from the received harvested tissue.
- the collection vessel is configured for use in a centrifuge. Alternatively/additionally, the collection vessel may be configured to be received in a container for use in a centrifuge.
- the delivery vessel is couplable with a delivery device.
- the polymer composition is functionalised to achieve in situ stabilisation of the polymer composition under activation conditions.
- the polymer composition comprises a photoinitiator and the activation conditions comprise exposure to light such as visible light comprising a wavelength of about 405 nm, optionally at about 20 mW/cm2.
- the activation conditions may comprise exposure to the light for about 60 to about 120 seconds.
- the polymer composition comprises at least one of: gelatin methacryloyl (GelMA) (e.g., Type A obtained from porcine skin, bloom 300, with from about 80% to about 90% methacryloyl functionalisation); and methacrylated alginate-RGD (e.g., about 270 to about 280 kDa alginate with M/G ratio of approx.1.3-1.4, about 40-60% (preferably 40-50%, e.g., 45-46%) methacrylate functionalisation (as a % of functionalised monomers) and 5-6% RGD (as a wt% substitution of reactive groups).
- GelMA gelatin methacryloyl
- methacrylated alginate-RGD e.g., about 270 to about 280 kDa alginate with M/G ratio of approx.1.3-1.4
- about 40-60% preferably 40-50%, e.g., 45-46%) methacrylate functionalisation (as a % of functionalised
- the harvested tissue is adipose tissue, preferably infrapatellar fat pad tissue.
- the tissue being treated or repaired or regenerated is cartilage, preferably articular cartilage.
- An aspect of the present disclosure also provides a method for treating, or repairing, or regenerating tissue comprising use of the apparatus according to the foregoing.
- An aspect of the present disclosure also provides a composition for treating, or repairing, or regenerating tissue, prepared using the apparatus or the method according to the foregoing.
- the present disclosure provides a method for repairing or regenerating a tissue to treat a tissue defect comprising the steps of: processing harvested tissue to separate a cellular fraction (e.g., Stromal Vascular Fraction (SVF)) or cellular extract from the harvested tissue; preparing a cell loaded polymer composition by mixing the cellular fraction (e.g., SVF) or cellular extract with a polymer composition; administering the cell loaded polymer composition to the tissue defect; and activating the cell loaded polymer composition for in situ stabilisation of the polymer composition to allow for cell ingrowth and tissue repair or regeneration; wherein the method is performed in a single sterile environment.
- a cellular fraction e.g., Stromal Vascular Fraction (SVF)
- cellular fraction e.g., SVF
- the method comprises the step of obtaining the harvested tissue from a donor subject in the single sterile environment.
- processing the harvested tissue comprises using at least one filter while centrifuging to separate the fraction (e.g., SVF) or cellular extract from the remainder of the harvested tissue.
- the polymer composition is pre-loaded in at least one of a collection vessel into which the cellular fraction (e.g., SVF) or cellular extract is received, and a delivery vessel from which the cell loaded polymer composition is delivered to the site of defect or injury.
- the pre-loaded polymer composition is in a solid or gel state and the method comprises inducing a solid to liquid phase change before mixing the polymer composition with the cellular fraction (e.g., SVF) or cellular extract.
- the solid to liquid phase change is achieved by at least one of a thermal mechanism and a chemical agent.
- at least one of a collection vessel and a delivery vessel is preloaded with a liquid volume of the polymer composition before mixing with the cellular fraction (e.g., SVF) or cellular extract.
- mixing comprises, at least, transferring the cellular fraction (e.g., SVF) or cellular extract and any polymer composition from the collection vessel into a delivery vessel where the cellular fraction (e.g., SVF) or cellular extract in mixture with the polymer composition, forms the cell loaded polymer composition.
- the activating step achieves in situ stabilisation of the polymer composition.
- the polymer composition contains a photoinitiator and the activating step comprises exposing the cell loaded polymer composition to light.
- the method comprises adding a photoinitiator before administering the cell loaded polymer composition to the tissue defect.
- the activating step comprises exposing the cell loaded polymer composition containing a photoinitiator to visible light comprising a wavelength of about 405 nm at about 20 mW/cm 2 for about 60 toto about 120 seconds.
- the polymer composition comprises at least one of: gelatin methacryloyl (GelMA) (e.g., Type A obtained from porcine skin, bloom 300, with from about 80% to about 90% methacryloyl functionalisation); and methacrylated alginate-RGD (e.g., about 270 to about 280 kDa alginate with M/G ratio of approx.1.3-1.4, about 40-60% (preferably 40-50%, e.g., 45-46%) methacrylate functionalisation and 5-6% RGD (as a wt% substitution or reactive groups).
- the harvested tissue is adipose tissue, preferably infrapatellar fat pad tissue.
- the tissue being treated or repaired or regenerated is cartilage, preferably articular cartilage.
- An aspect of the present disclosure also provides the method according to the foregoing, performed using the apparatus according to the foregoing.
- Another aspect of the present disclosure provides a kit for treatment or repair or regeneration of tissue, the kit comprising the apparatus according to the foregoing, provided in pre-assembled or unassembled condition in a kit container.
- the kit comprises a solid to liquid phase change agent being a thermal heat source (e.g., incubator) and/or a chemical agent (e.g., a chelator such as EDTA).
- the kit comprises a photoinitiator.
- the kit comprises a delivery device couplable with the delivery vessel.
- the kit comprises a pre-treatment component configured to mechanically process the harvested tissue before it is received in the collection vessel.
- the kit comprises a light source for activating the prepared composition in vivo.
- the present disclosure provides an apparatus for use in preparation of a composition for treatment or repair or regeneration of tissue, the apparatus comprising: a collection vessel configured to receive harvested tissue; and at least one filter element located inside the collection vessel; wherein the apparatus is configured to be received in a centrifuge to separate a Stromal Vascular Fraction (SVF) from the harvested tissue within the collection vessel; wherein at least a portion or extract of the SVF separated from the harvested tissue in the apparatus is used in preparation of a treatment composition comprising a mixture of SVF or extract and a polymer composition for treatment or repair or regeneration of the tissue.
- the apparatus comprises a collection container for receiving the separated SVF and which is removably couplable with the collection vessel.
- the apparatus comprising the collection container when coupled with the collection vessel may be configured to be received within a centrifuge, or within a centrifuge tube, for use in a centrifuge.
- the at least one filter element may comprise a plurality of openings of about 30 to 60 um, preferably about 40 ⁇ m. The openings may be provided in a strainer of the filter element a will be explained below.
- the filter element comprises a hollow filter barrel configured to be received within the collection vessel, and to receive the harvested tissue therein in sue.
- the filter barrel comprises at least one strainer configured for separation of the SVF from the received harvested tissue.
- the apparatus comprises a spacer to separate the filter barrel from an end of the collection vessel when in use.
- the apparatus comprises or is provided with a polymer container containing the polymer composition.
- the polymer container may comprise a syringe or other suitable container.
- the polymer container may comprise one or both of the collection vessel and a pre-loaded syringe.
- the polymer container may comprise a volume of liquid polymer composition.
- the apparatus comprises or is provided with a delivery vessel for receiving the prepared treatment composition, and optionally wherein the delivery vessel is couplable with a delivery device.
- the polymer composition is functionalised to achieve in situ stabilisation of the polymer composition under activation conditions.
- the polymer composition may comprise a photoinitiator and the activation conditions may comprise exposure to visible light.
- the visible light may comprise a wavelength of about 405 nm, optionally at about 20 mW/cm 2 and optionally for about 60 seconds to about 150 seconds, preferably about 120 seconds.
- the polymer composition comprises at least one of: gelatin methacryloyl (GelMA); and methacrylated alginate-RGD.
- the harvested tissue is adipose tissue, preferably infrapatellar fat tissue.
- the tissue being treated or repaired is cartilage, preferably articular cartilage.
- An aspect of the present disclosure also provides a method for treating, or repairing, or regenerating tissue comprising use of the apparatus according to the foregoing.
- An aspect of the present disclosure also provides a composition for treating, or repairing, or regenerating tissue, prepared using the apparatus or the method according to the foregoing.
- the present disclosure provides a method for repairing or regenerating tissue to treat a tissue defect comprising the steps of: processing harvested tissue to separate a Stromal Vascular Fraction (SVF) from the harvested tissue; preparing a treatment composition comprising a cell loaded polymer composition by mixing at least a portion of the SVF or an extract thereof with a polymer composition; administering the treatment composition comprising the cell loaded polymer composition to the tissue defect; and activating the cell loaded composition for in situ stabilisation of the polymer composition to allow for cell ingrowth and tissue repair or regeneration; wherein the method is performed in a single sterile environment.
- the method comprises the step of obtaining the harvested tissue from a donor subject in the single sterile environment.
- the donor subject may be a patient having the tissue defect to be treated.
- processing the harvested tissue comprises using at least one filter while centrifuging to separate the SVF.
- the method comprises collecting harvested tissue using an attachment connected in a suction path of an arthroscope instrument used to remove the harvested tissue from the donor subject.
- mixing comprises, at least, transferring at least a portion the separated SVF or extract thereof and a volume of the polymer composition into a delivery vessel where the SVF portion or extract thereof, in mixture with the polymer composition, forms the cell loaded polymer composition.
- the treatment composition may comprise the cell loaded polymer composition alone or in combination with one or more bioactive molecules (for example, one or more of growth factors, interleukins, and anti- clotting agents) or other factors.
- mixing comprises combining a volume of the separated SVF or extract thereof with a buffer solution before mixing with the polymer composition.
- mixing comprises transferring a volume of the polymer composition into the combined SVF or extract and buffer solution, or vice versa, to form the cell loaded polymer composition.
- the treatment composition comprising the cell loaded polymer composition contains a photoinitiator and the activating step comprises exposing the treatment composition comprising the cell loaded polymer composition to light.
- the activating step comprises exposing the treatment composition comprising the cell loaded composition to visible light.
- the visible light may comprise a wavelength of about 405 nm, optionally at about 20 mW/cm 2 and optionally for about 60 seconds to about 150 seconds, preferably about 120 seconds.
- the polymer composition comprises at least one of: gelatin methacryloyl (GelMA); and methacrylated alginate-RGD.
- the harvested tissue is adipose tissue, preferably infrapatellar fat tissue.
- the tissue being treated or repaired is cartilage, preferably articular cartilage.
- kits for preparation of a composition for treatment or repair or regeneration of tissue comprising: the apparatus according to the foregoing.
- Components of the kit may be provided in pre- assembled or unassembled condition in a kit container.
- the kit comprises an attachment for collecting harvested tissue, the attachment configured to be connected in a suction path of an arthroscope instrument used to remove the harvested tissue from a patient.
- the kit comprises a light source for activating the prepared composition in vivo.
- an attachment for collecting material removed from a surgical site comprising: an attachment body; an attachment inlet couplable with an arthroscope instrument configured for removing material from the surgical site by suction; and an attachment outlet configured for fluid communication with a vacuum pump; wherein the attachment inlet and attachment outlet are arranged such that in use, application of a vacuum at the attachment outlet draws an airstream containing material from the surgical site into the attachment inlet, and liquid and solid material in the airstream drop into the body.
- the attachment inlet and the attachment outlet are provided on an upper portion of the attachment.
- the attachment inlet comprises a channel extending inside the attachment body such that in use, the airstream from the surgical site is required to change direction before exiting the attachment through the attachment outlet.
- the attachment comprises an attachment lid which is removable from the attachment body. One or both of the attachment inlet and the attachment outlet may be provided through the lid.
- the attachment may comprise an attachment container which is removably couplable with the attachment body and into which the liquid and solid material is collected when in use. [0077]
- An aspect of the present disclosure also provides the method according to the foregoing, or an apparatus according to the foregoing, used with or incorporating to the attachment.
- FIG. 1 is a schematic illustration of an apparatus for preparation of a treatment composition comprising a filter barrel inserted inside a collection vessel.
- Figures 2a to 2d are a top, side, bottom and sectional view (taken through the line A-A in Figure 2b), showing a schematic illustration of the filter barrel of Figure 1.
- Figure 3 is a schematic illustration of an apparatus for preparation of a treatment composition comprising a strainer attached to or formed integrally with an interior of a collection vessel.
- Figures 4a to 4d are a side, perspective, top and sectional view (taken through the line A-A in Figure 4c), showing a schematic illustration of an alternative filter barrel arrangement inside a collection vessel.
- Figure 4e is an enlarged view of the portion marked B in Figure 4d.
- Figure 5a is an isometric view of an apparatus for preparation of a treatment composition comprising a filter barrel comprising elements assembled inside a collection vessel.
- Figure 5b is an exploded view of the apparatus of Figure 5a.
- Figure 5c is a side view of the filter barrel and a spacer forming part of the apparatus of Figures 5a and 5b.
- Figure 5d is an end view of the filter barrel showing a strainer.
- Figure 5e is a sectional view of the filter barrel and spacer of Figure 5c, taken through line A-A.
- Figure 6 is an isometric view of a connector and collection container couplable with the apparatus of Figures 1 to 5d.
- Figure 7 is an isometric view of the apparatus of Figures 5a to 5e coupled with the collection container of Figure 6 with a cap applied over.
- Figure 8a is an isometric view of the assembly of Figure 7 inserted within a centrifuge tube.
- Figure 8b is a top view of Figure 8a.
- Figure 8c is a sectional view taken through the line A-A in Figure 8b.
- Figure 9a is an isometric view of an attachment for receiving harvested tissue during an arthroscopic procedure.
- Figure 9b is a top view of the attachment of Figure 9a.
- Figure 9c is a sectional view taken through the line B-B in Figure 9b.
- Figure 10 is a schematic representation of a method 500 for preparing a treatment composition involving use of a collection vessel that is preloaded with a volume of functionalised polymer.
- Figure 11 is a schematic representation of a method 600 for preparing a treatment composition involving use of a delivery vessel that is preloaded with a volume of functionalised polymer.
- Figures 12a and 12b are a schematic representation of a method 700 for preparing a treatment composition involving use of a product vessel that is preloaded with a volume of functionalised polymer.
- Figures 13 to 16 are schematic illustration of kits for use in preparation of a treatment composition.
- Figure 17 illustrates a histological analysis of samples taken from cartilage defects 1 month after surgery, in accordance with Example 1, showing the effect of the cellular and biomaterial composition delivered at 50% in bioscaffolds made of GelMa 10%, LAP 0.1%, photocrosslinked at 20 mW/cm 2 for 1 min.
- a) Images show a comparison between native cartilage (“Cartilage”), cartilage with a 4 mm diameter lesion generated with a biopsy punch left untreated (“Empty”), or cartilage with a 4 mm diameter lesion generated with a biopsy punch and treated with the cell loaded polymer composition (“SVF”).
- Cartilage native cartilage
- Empty left untreated
- SSF cell loaded polymer composition
- FIG. 18 illustrates a cell loaded polymer composition produced according to Example 2.
- the cell loaded polymer composition was delivered in PDMS moulds and solidification was achieved via photocrosslinking with light using 405 nm light source at 20mW/cm2 for 1 minute.
- the magnified area shows the immunostaining analysis performed on the whole bioscaffolds right after solidification (Day 0), using DAPI to stain the cell nuclei and anti-collagen type II.
- FIG. 1 The histograms show the quantification of glycosaminoglycan and DNA performed on the bioscaffolds at day 0 and after 21 days of culture using papain extraction followed by DMMB quantification (GAG) and Pico Green quantification (DNA) (as outlined in Onofrillo, et al., 2021, Biomaterials, 264, 120383).
- GAG DMMB quantification
- DNA Pico Green quantification
- Figure 19 illustrates the cellular fraction (i.e., SVF) retrieved following the procedure of Example 3.
- the present disclosure relates to use of novel apparatus, kits, systems and methods for preparation of a treatment composition comprising a cell loaded polymer composition that can be injected locally to deliver the cells to the site of injury and can subsequently provide an environment for cell ingrowth and tissue repair.
- the present disclosure enables both preparation and delivery of the treatment composition to the site of defect or injury to be performed in a single sterile environment in a single surgical procedure without the need for cell expansion. Resultant benefits, include simplification of the procedure as well as reduction in time, cost and risk of contamination.
- polymer refers to homopolymers (formed by polymerisation of a single monomer species) and co-polymers (formed by polymerisation of a plurality of different monomer species), including linear polymers and cross-linked polymers.
- the polymer can be a non-crosslinked or sparsely cross-linked polymer.
- the polymer can be crosslinked.
- functionalised polymer refers to a polymer in which at least a portion of the individual monomer units are substituted with a specific functional group, for example, a functional group such as a methacryloyl group, that facilitates irreversible cross-linking of the polymer.
- phase change will be understood to refer to a change in physical state, for example, a change to a solid (including gel) or a liquid phase. In some embodiments, the phase change may be reversible.
- a phase change from solid to liquid increases the flowability of the functionalised polymer to, for example, allow for delivery of the polymer and/or mixture with the cellular fraction (e.g. SVF) or extract obtained from the harvested tissue.
- a phase change from liquid to solid decreases the flowability of the functionalised polymer to, for example, to make it suitable for storage or transport or to increase the shelf life prior to mixture with the cellular fraction (e.g. SVF) or extract, or to allow for cell in growth and tissue repair or regeneration following administration of the cell loaded polymer composition to the tissue [0100]
- An example of a functionalised polymer suitable for use with some embodiments disclosed herein is described in International patent application PCT/AU2022/051439 the entire contents of which is hereby incorporated herein by this reference.
- an “amine reactive group” or “hydroxyl reactive group” or “carboxyl reactive group” can be any functional group able to react with an amine group, or hydroxyl, or carboxyl group, respectively.
- the polymer is alginate.
- alginate having a M/G ratio of about 1.30.
- the alginate has a molecular weight of about 270 kDa.
- the alginate can be reversibly crosslinked when combined with an ionic crosslinking agent, preferably a divalent cation, more preferably Ca2+.
- the polymer is functionalised with a plurality of photocrosslinkable moieties (e.g., methacryloyl groups reacted with a hydroxyl group, a carboxyl group or an amine group of the polymer, for example, methacrylate groups reacted with a hydroxyl group of alginate) capable of crosslinking when combined with a photoinitiator and exposed to light.
- the functionalised polymer is methacrylated alginate with, for example, approximately 45-46% methacrylate functionalisation.
- the polymer is functionalised with a plurality of cell adhesion moieties, for example a peptide with cysteine and/or thiol (-SH) functionality.
- the peptide comprises an integrin binding motif, for example, an Arg- Gly-Asp (RGD) (SEQ ID NO:1), RGDS (SEQ ID NO:2), GGGGRGDSP (SEQ ID NO:3), GRGDSP (SEQ ID NO:4), or GRGDS (SEQ ID NO:5), or an amino acid sequence with 1 or 2 amino acid insertions, deletions, substitutions (preferably conservative substitutions) or a combination thereof, typically outside the RGD motif.
- RGD Arg- Gly-Asp
- the peptide for cell adhesion may preferably comprise a cysteine residue and a RGD cell adhesion motif, for example, CRGDS (SEQ ID NO:6).
- RGD-based peptide sequences are introduced into methacrylated alginate via a thiol-Michael (e.g., methacrylate groups reacted with peptide to produce methacrylated alginate-RGD with for example, 5-6% RGD, as a wt% substitution of reactive groups).
- the functionalised polymer is about 270 to about 280 kDa alginate with M/G ratio of approx.1.3-1.4, about 40-60% (preferably 40-50%, e.g., 45-46%, as a % of functionalised monomers) methacrylate functionalisation and 5-6% RGD (as a wt% substitution of reactive groups.
- the polymer is a bovine or porcine gelatine functionalised with methacryloyl groups, designated gelatin methacryloyl (GelMA).
- the GelMA has between about 80 and about 90% methacryloyl functionalisation, for example, about 84% methacryloyl functionalisation.
- the functionalised polymer is Type A gelatin obtained from porcine skin, bloom 300, with from about 80% to about 90% methacryloyl functionalisation, for example, about 84% methacryloyl functionalisation.
- a “polymer composition” can comprise one or more polymers and/or functionalised polymers whether crosslinked or not, solubilised in solvent (e.g., aqueous medium such as water or saline solution) or solvated in solvent.
- the polymer composition can also comprise, for example, one or more divalent cations, more preferably Ca2+; one or more chelators such as EDTA; and/or one or more photoinitiators (e.g., c lithium phenyl-2,4,6 trimethylbenzoylphosphinate (LAP)).
- the polymer composition can be in a solid (including a gel state) or a liquid state.
- the polymer composition has a concentration of, for example, from about 4% to about 20% (w/v) GelMA, preferably about 12% to about 16% (w/v) GelMA, for example about 6%, 8%, 10%, or 20% (w/v) GelMA.
- the polymer composition has a concentration of, for example, from about 4% to about 20% (w/v), preferably about 8% to about 10% (w/v) methacrylated alginate-RGD in solvent.
- the polymer composition may also comprise the photoinitiator, lithium phenyl-2,4,6 (LAP) at a final concentration of, for example, 0.05% or 0.1% or 0.2% (w/v).
- LAP lithium phenyl-2,4,6
- Cross-linking a polymer composition can change the state of the polymer composition from a “liquid” to a “solid” or “gel”. The cross-linking may or may not be reversible.
- Cross-linking can be used to modify the behaviour and/or mechanical properties of the resulting polymer networks, for example, modify, the viscosity, solubility, mechanical strength, stiffness, and/or rigidity.
- polymer networks can be obtained by either chemical or physical (e.g., ionic cross-linking).
- the cross-links are formed by covalent chemical bonds, or by physical interaction (e.g., ionic bonds), respectively.
- one or more of the monomers of the polymer(s) comprise cross-linkable groups.
- cross-linkable groups are selected from: hydroxyl groups, acid groups, aldehyde groups, carbonyl groups, amine groups, and oxirane groups.
- these functional groups are derived from esters or amides of methacrylic acid.
- Physically cross-linked networks possess temporary connections either through polymeric chain entanglement or physically induced gelation through, for example, ionic interaction, hydrogen bonding, thermo-induced gelation, complementary binding, inclusion complex formation, and hydrophobic interactions. Physical cross-linking can be reversed by for example a change in pH, temperature, ion concentration, or addition of a chelator such as EDTA).
- Chemically crosslinked networks are typically not reversible.
- crosslinking through photopolymerisation involves polymers with vinylic such as methacryloyl groups, which allow for photopolymerisation.
- vinylic double bond renders the compound highly sensitive to free radicals generated by an initiator under UV radiation and consequently to chain polymerisation.
- Some covalent interactions are “reversible”, these are often called “dynamic covalent interactions” and include Schiff click chemistry, and Michael addition.
- “chemically cross-linked networks” as used herein can refer to “permanent” or “reversible” networks.
- phase change Change in state from solution (also referred to herein as “liquid”) to solid or gel, or vice versa, can be referred to as a “phase change” or “phase transition”.
- phase change or “phase transition” will be understood to refer to a change in physical state, for example, a change to a solid (including gel) or a liquid phase. And the change may or may not be reversible. Static covalent cross-links are not reversible.
- a phase transition in the cross-linked polymer chain conformation can be induced that leads to a change of the properties of the macroscopic network.
- the phase transition may change the viscosity of the polymer composition and its flow properties to make it suitable for, for example, injectability, or to improve its draw rate.
- a phase change from solid to liquid may increase the flowability of the functionalised polymer to, for example, allow for delivery of the polymer and/or mixture with the cellular fraction (e.g. SVF) or extract obtained from the harvested tissue.
- a phase change from liquid to solid may change the viscosity of the polymer composition and its flow properties to make it suitable for storage or transport or to increase the shelf life.
- the polymer composition can be cross-linked for in situ stabilisation of the polymer composition as a function of, for example, chemical agents, physiological stimuli (such as temperature, pH and ionic concentration) or light (which requires the introduction of a photoinitiator) to, for example, allow cell in growth and tissue repair or regeneration.
- Polymer compositions and cross-linking strategies envisioned for biomedical applications should be biocompatible, and preferably, they (i) should not trigger an excessive inflammatory response, (ii) be biodegradable within a desired time frame (unless envisioned as permanent implant), (iii) be cleared from the body without the production of toxic byproducts, and (iv) provide the appropriate environment for cell proliferation and tissue growth.
- polymer compositions for cartilage regeneration allow for ease of administration under physiological conditions, (ii) are injectable (with gelation following injection via either chemical or physical cross-linking), (iii) biocompatible and potential biodegradable, (iv) mimic cartilaginous extracellular matrix features and promote chondrogenic potential of cells, (v) fill defect sites inside the joint and integrate with the surrounding native cartilage tissue rather than shifting readily and (vi) have a sustained release profile if associated with local drug delivery.
- the polymer composition may be a hydrogel.
- Hydrogels are a class of polymer materials that possess high water content and elastic properties with cross-linked (e.g., through covalent bonds or held together via physical intramolecular and intermolecular attractions), multiporous networks. Hydrogels can be classified into different categories based on various parameters such as preparation method, ionic charge, and mechanical and structural characteristics. [0127] Hydrogels can be broadly classified based on the source material (natural or synthetic) and biodegradability (biodegradable or non-biodegradable). Natural hydrophilic macromolecules used for hydrogel scaffold fabrication are often biodegradable and mainly consist of proteins and polysaccharides.
- Natural polymers commonly used for the formation of hydrogels include gelatin, collagen, hyaluronic acid, alginate, fibrin, and chitosan, while synthetic polymers include poly(ethylene glycol) (PEG), poly(vinyl alcohol) (PVA), polydioxanone, poly(lactic acid)and poly(N-isopropylacrylamide). These polymers can be functionalised with one or more functional groups to make physically or chemically cross- linked hydrogels. [0128] Any technique which can be used to create a cross-linked polymer can be used to produce a hydrogel. Common noncovalent chemical interactions used for the design of hydrogels include electrostatic, metal coordination, hydrophobic, and hydrogen bonding.
- Covalent crosslinking can be done through numerous approaches including through chemical reactions of complementary groups.
- chemical reactions employed in cross-linking hydrogels are preferably achievable in aqueous solutions without generating toxic by- products.
- the reaction is preferably efficient with few reactants and active functional groups remaining.
- click chemistry Michael additions, thiol-ene/yne coupling, Diels- Alder reaction, disulfide formation, Schiff-base formation, and epoxide reactions are examples of suitable reactions that can be used.
- a number of hydrogel-based scaffolds have been developed that can be used in cartilaginous tissue engineering, and sufficient mechanical properties for repairing cartilage defects to restore normal joint function.
- a polymer composition for example, an hydrogel, can be used as carrier for live cells (e.g., live stem or progenitor cells) to deliver the cells to the defect site and stimulate tissue repair or regeneration.
- live cells e.g., live stem or progenitor cells
- Examples of cells that can be incorporated into the polymer composition include one or more of chondrocytes, progenitor cells and stem cells (e.g., endothelial progenitor cells (EPCs), mesenchymal stromal cells (MSCs), induced pluripotent stem cells (iPSCs) and predifferentiated MSCs).
- EPCs endothelial progenitor cells
- MSCs mesenchymal stromal cells
- iPSCs induced pluripotent stem cells
- predifferentiated MSCs predifferentiated MSCs.
- a cellular fraction or extract thereof for example, obtained from a harvested tissue is incorporated into the polymer composition, for example, an hydrogel.
- the cellular fraction or extract is obtained from adipose tissue.
- the cellular fraction may be a “stromal vascular fraction”.
- the stromal vascular fraction may comprise one or more of the following cell types; adipocytes, fibroblasts, smooth muscle cells, endothelial cells, blood cells, EPCs, preadipocytes, vascular progenitors, hematopoietic progenitors, MSC, hematopoetic stem cells (HSC), pericytes, supra-adventicial cells.
- the cellular fraction or extract thereof may be diluted with, for example, a buffer solution (e.g., saline) prior to being mixed with the polymer composition to form a “cell loaded polymer composition”.
- the cell loaded polymer composition may also be diluted with, for example, a buffer solution (e.g., saline) prior to delivery to the defect site.
- a buffer solution e.g., saline
- the cellular fraction e.g., diluted to about 5% to about 20% in a buffer solution prior to being mixed with the polymer composition, for example, at a 1:1 ratio.
- the polymer composition is gelatin methacryloyl (GelMA) and on mixing with the cellular fraction (e.g., SVF), the GelMA is diluted to about 2% to about 10% (v/v), preferably about 6% to about 8% (v/v).
- the polymer composition is methacrylated alginate-RGD and on mixing with the cellular fraction (e.g., SVF) is diluted to about 2% to about 6% (v/v), preferably about 4% to about 5% (v/v).
- the present disclosure allows for control of the ratio of cellular fraction or extract thereof to polymer composition.
- the treatment compositions of the disclosure comprise one or more bioactive molecules, for example, one or more chemical mediators such as growth factors, interleukins.
- the polymer composition is in a solid or gel state prior to administration and a phase transition in the cross-linked polymer chain conformation is induced that leads to a change of state to a “liquid” form with lower viscosity allowing it to be mixed with the cellular fraction or extract and/or collected (e.g., drawn into a delivery vessel), and/or delivered to the defect site (e.g., from the delivery vessel by injection).
- the polymer composition may be supplied in a liquid state allowing it to be mixed with the cellular fraction or extract and/or collected without requiring a prior phase change.
- the cell loaded polymer composition can, for example, be delivered to the defect site in an open surgery or non-invasive or minimally invasive manner by, for example, direct injection or arthroscopy.
- the cell loaded polymer composition is of suitable viscosity to allow for homogenous delivery and distribution of the cells inside the tissue defect (e.g., cartilage defect).
- the cell loaded polymer compositions can fill the defect area, preferably with a smooth interface (e.g., that is similar to the native cartilage), preferably without integrating into the surrounding healthy tissue.
- the cell loaded polymer compositions allow for cell in growth and tissue repair or regeneration of the defect.
- Histological analysis of in vitro or ex vivo samples can be used to quantify the degree of tissue repair or regeneration.
- haematoxylin and eosin (H&E) staining of nuclei and extracellular matrices, respectively can report on aspects of the tissue cellular structure (for example, defect area thickness).
- a macroscopic score can also be calculated using the histological analysis, according to the ICRS Clinical Cartilage Injury Evaluation system-2000, cartilage injury evaluation standard (accessible at https://cartilage.org/content/uploads/2014/10/ICRS_evaluation.pdf).
- a defect area treated with a cell loaded polymer composition of the disclosure will have a similar macroscopic score when compared with healthy tissue 1 month after treatment. In further or alternative embodiments, a defect area treated with a cell loaded polymer composition of the disclosure will have a greater macroscopic score than a defect area left untreated, 1 month after treatment.
- Cellular imaging may also be used to assess structural characteristics of a defect area. For example, second harmonic generation (SHG) microscopy can be used to visualise the fibrillar type II collagen structures present in cartilage tissue.
- SHG second harmonic generation
- a defect area treated with a cell loaded polymer composition of the disclosure will have a similar relative amount of collagen in a ROI, collagen fibre density, collagen reticulation index, and number of collagen fibres per square millimetre, compared with healthy tissue 1 month after treatment.
- a defect area treated with a cell loaded polymer composition of the disclosure will have a greater relative amount of collagen in a ROI, collagen fibre density, collagen reticulation index, and number of collagen fibres per square millimetre, when compared with a defect area left untreated, 1 month after treatment.
- Treatment efficacy may also be assessed by quantifying the cellular processes that regulate cartilage degeneration, and/or homeostasis after treatment. For example, fibroblast growth factor 2 (FGF-2) promotes regeneration of cartilage by attracting mesenchymal stem cells to the site of cartilage injury.
- FGF-2 fibroblast growth factor 2
- FGF-2 levels may indicate the potential promotion of cartilage repair as a result of treatment, as FGF-2 that stimulates native cartilage repair; FGF-2 levels may be measured by any suitable technique known in the art (for example, enzyme-linked immunosorbent assay (ELISA)).
- FGF-2 levels in cartilage defect areas treated with a cell loaded polymer composition of the disclosure, compared to untreated tissue may indicate an increased repair potential.
- Another measure of treatment efficacy is the metabolic activity of cells at the defect area, after treatment with the cell loaded polymer composition, which may be measured by any suitable technique known in the art (for example, Cell Titer Blue Assay, Promega).
- human adipose derived stem cells may have increased metabolic activity after treatment with a cell loaded polymer composition of the disclosure, compared to a saline treatment.
- the apparatus 100 comprises a collection vessel 110 configured to receive harvested tissue and at least one filter element located inside the collection vessel to assist with separation of a cellular fraction, for example, a Stromal Vascular Fraction (SVF) fraction, from the harvested tissue within the collection vessel.
- the filter element comprises a filter member or strainer 112 located inside the collection vessel 110 when in use so as to aid in separation of the cellular fraction (e.g., SVF) from the harvested tissue.
- the filter element comprises a hollow filter barrel 120 with a strainer 112 at one end.
- the filter barrel 120 is insertable into the collection vessel 110 such that the strainer 112 sits inside the collection vessel when assembled.
- Harvested tissue can be loaded into the through opening 126.
- FIGS 2a to 2d are a top, side, bottom and sectional view (taken through the line A-A of Figure 2b) of the filter barrel of Figure 1.
- the top and sectional views in Figures 2a and 2d show the threaded luer coupling 128 for attachment of a syringe containing the harvested tissue.
- the bottom and sectional views in Figures 2c and 2d show the strainer 112.
- Collection vessel 110 may comprise a bottom opening 118 having a narrowing or neck that is couplable with e.g. a delivery device 140 or a valve connector 150 via a luer coupling or the like.
- a removable stand 124 may be provided over the bottom opening 118 to retain the collection vessel 110 in an upright condition.
- the filter element comprises a strainer 112 attached to, or formed integrally with, an interior wall of the collection vessel 110. Harvested tissue may be loaded directly into the top opening 116 of the collection vessel, atop the strainer 112.
- An advantage of providing the filter element or strainer 112 attached to or formed integrally with an interior wall of the collection vessel includes reduction of parts and materials, and the ability to sterilise the apparatus as a single piece.
- the apparatus comprising the collection vessel 110 may be manufactured with the interior filter element/strainer integral to the vessel using a sterile single process such as injection moulding which may reduce cost associated with materials.
- eliminating the process of transferring harvested tissue from a filter barrel to the collection vessel interior may reduce loss of harvested tissue which may be important when dealing with small volumes.
- filter barrel 120 is open at a top end and a removable closure 130 is provided to close the filter barrel after receiving the harvested tissue to avoid loss of materials, for example as the apparatus containing the tissue is transferred into the centrifuge.
- two filter elements 112a, 112b are provided in filter barrel 120 as shown in the enlarged sectional view of Figure 4e. It is to be noted that the two filter elements need not arranged proximal one another as shown. In some embodiments they may be spaced further apart such that one filter element 112b is arranged e.g. at or near the end of the filter barrel 120, and the other filter element 112a positioned somewhere between e.g. the mid point of the filter barrel and the first filter element 112b.
- FIG. 5a Another example of an apparatus 100 comprising a collection vessel 110 and a filter barrel 120 is provided in Figures 5a to 5e.
- the filter barrel 120 comprises a strainer 112 which may be located inside or at/toward one end of the filter barrel which is insertable into the collection vessel 110 such that the strainer 112 sits inside the collection vessel when assembled.
- the apparatus 100 may be provided pre-assembled, which may streamline use of the apparatus in preparation of a treatment composition.
- Figure 5a shows the assembled open apparatus 100.
- strainer 112 is arranged at one end of the filter barrel 120.
- a spacer 123 may be provided to create a space for the cellular fraction (e.g.
- strainer 112 may be set back inside the filter barrel body 120, obviating the need for a spacer 123. In some embodiments, more than one strainer may be provided in the filter barrel 120, with or without a spacer 123. [0147] To assemble the apparatus 100 as shown in Figures 5a-e, the spacer 123 is inserted into the collection vessel 110 followed by the filter barrel 120. In some examples, the filter barrel 120 may be retained within the collection vessel 110 by a friction fit to limit the risk of disassembly and/or e.g. loss of harvested tissue during transfer into a centrifuge and/or use of the apparatus to prepare a treatment composition.
- the apparatus may comprise a closure 130 which can be applied to the open end 126 of the filter barrel to prevent loss of contents.
- the closure 130 ( Figure 5b) may also retain the filter barrel 120 within the collection vessel 110 although a separate removable closure may be provided for this purpose.
- the collection vessel 110 may comprise a grasping portion such as flange 117.
- Collection vessel 110 may comprise a bottom opening 118 that is couplable with other components that may be useful for preparation of the treatment composition.
- the opening 118 may comprise a narrowing or neck as shown to couple with other components e.g. by luer lock, threaded or friction fit coupling or the like.
- Such components may include but are not limited to e.g.
- FIG. 6 is an example of a collection container 160 which may be coupled directly or indirectly, e.g. via a coupler 165 with the bottom opening 118 of the collection vessel 110.
- a collection container 160 may be utilised to collect the cellular fraction (e.g. SVF) after centrifuging of the harvested tissue in the apparatus 100.
- the cellular fraction e.g. SVF
- collection container 160 may be couplable with a closure (not shown) for retaining the sterile contents comprising the collected cellular fraction (e.g. SVF).
- the apparatus 100 may comprise a coupling (e.g. luer coupling 128 as in Figures 1, 2a-2d) for releasable attachment of a syringe or other device containing the harvested tissue from which the cellular fraction (e.g., SVF), is to be separated.
- the harvested tissue can be provided into the hollow body (e.g. via opening 116 as in Figure 3) of the collection vessel 110, above the strainer 112, without such a coupling.
- each strainer or filter element comprises a plurality of openings each having a cross-sectional dimension of about 30 to 60 um, preferably about 40 ⁇ m.
- Each strainer or filter may comprise a nylon or other material.
- or filter element comprises a membrane having a molecular weight cut-off ranging from about 50 to about 500 kDA for separation of the cellular fraction (e.g., SVF) from the harvested tissue.
- the apparatus 100 containing the harvested tissue is configured to be receivable in a centrifuge where the process of centrifuging can be undertaken to separate the cellular fraction (e.g., SVF) through the filter element 112 and into the bottom part 114 of collection vessel 110, or into a collection container 160 coupled with the collection vessel 110.
- Figure 7 is an isometric view of the apparatus of Figures 5a to 5e coupled with the collection container of Figure 6 with an open centrifuge cap 175 applied over. Cap 175 enables the centrifuge tube 170 to be used as a support vessel for the apparatus 100. This enables a standard centrifuge tube holder to be used to hold the apparatus 100.
- Figure 8a is an isometric view of the assembly of Figure 7 inserted within a centrifuge tube 170, such as a falcon tube.
- Figure 8b is a top view of Figure 8a.
- Figure 8c is a sectional view taken through the line A-A in Figure 8b.
- the centrifuge tube 170 and centrifuge cap 175 may be threadedly engaged to secure the apparatus 100 containing the harvested tissue, for insertion into the centrifuge tube holder.
- Utilisation of the centrifuge tube 170 and cap 175 improves accommodation of the apparatus 100 within the centrifuge tube holder, while continuing to maintain sterility of the contents.
- a centrifuge tube 170 may be utilised to receive the apparatus 100 within the centrifuge tube holder, with or without a collection container 160.
- the apparatus may comprise or be coupled with a delivery vessel 140 ( Figures 10 and 11).
- the delivery vessel 140 may be couplable with the collection vessel 110 using e.g. luer couplings.
- the coupling between the collection vessel 110 and the delivery vessel 140 may comprise a valve as will be described with reference to Figure 11.
- the apparatus may comprise or be coupled with a delivery vessel 140 which is utilised to transport the cell loaded polymer composition to the site for repair.
- apparatus 100 is configured to receive a volume of a polymer composition for mixing with the fraction (e.g., SVF) obtained from the harvested tissue.
- the polymer composition may be received or provided in either one of the collection vessel 110 and the delivery vessel 140 as described with reference to various embodiments herein. Alternatively, it is contemplated that part of the volume of the polymer composition may be received or provided in both the collection vessel 110 and the delivery vessel 140.
- the polymer composition may be provided in a pre-loaded polymer container which is couplable with a vessel containing the cellular fraction (e.g. SVF).
- the cellular fraction (e.g. SVF) or extract may be mixed with a buffer e.g.
- a delivery vessel 140 may be supplied separately from or in a kit with the apparatus which comprises the collection vessel and filter element.
- the collection vessel may be provided containing the polymer composition, and/or the delivery vessel may be provided containing the polymer composition.
- a polymer container may be provided containing the polymer composition which can be combined with the cellular fraction (e.g. SVF) to provide the prepared cell loaded polymer composition, as will be discussed below.
- the delivery vessel 140 can receive the cell loaded polymer composition prior to delivery to the defect site for regeneration or repair of the tissue using a delivery device such as a biopen or the like ( Figures 13 to 16).
- the cell loaded polymer composition may be received directly into a delivery device from the collection vessel 110.
- the cell loaded polymer composition may be prepared inside the collection vessel 110 and delivered directly to the defect site as described below.
- An example of a biopen suitable for use as a delivery device is described in WO2018/053565A1, the disclosure of which is incorporated herein by this reference. However, it is to be understood that this is just one example of a delivery device, and that other devices may be suitable for delivery of the cell loaded polymer composition to the defect site.
- the collection vessel 110 and/or the delivery vessel 140 may be pre-loaded with a volume of the polymer composition as will be described with reference to Figures 10 and 11.
- a polymer container may be pre- loaded with a volume of the polymer composition as will be described with reference to Figures 12a and 12b.
- container comprises a preloaded polymer syringe which may contain a known quantity of the polymer composition.
- apparatus 100 of Figures 1 to 2d is employed however it is to be understood that the apparatus of Figures 3 or 5a-e could be employed as alternatives.
- the apparatus is provided with the collection vessel 110 preloaded with a volume of polymer composition 585 in the bottom part 114 ( Figure 1) of the collection vessel 110. Under typical conditions the polymer composition 585 is solid at about 20 degC to about 25 degC.
- harvested tissue 580 is provided into the filter barrel 120.
- the tissue may be harvested arthroscopically or upon open surgery from e.g. the infrapatellar fat pad (IFP). IFP has been proven to be a good source for adipose derived stem cells e.g.
- IFP infrapatellar fat pad
- FIG. 9a to 9c show an attachment 900 for collection of harvested tissue from an arthroscope.
- Traditional arthroscope traps capture all material removed during the arthroscopic process which is typically collected for disposal. There is no easy way to remove the material once it has been captured in the trap and maintain sterility.
- Attachment 900 allows the material removed during the arthroscope procedure to be captured into a collection device instead of being captured in the trap. This allows the captured biological material comprising the harvested tissue to be used in the preparation of the treatment composition according to embodiments of present disclosure.
- Attachment 900 provides an attachment inlet 910 and attachment outlet 920 which enables the attachment to be connected in the arthroscope suction path, upstream of the vacuum pump which applies suction to remove material from the surgical site.
- a suction tube e.g. of approximately 10 cm length
- a further tube e.g. of approximately 100 cm length
- the attachment 900 is designed to utilise the suction flow to draw material from the arthroscope instrument into the attachment body 950.
- the solid and liquid material in the suction path falls out of the airstream into the arthroscope attachment body 950.
- air entering the attachment must change direction before exiting the attachment outlet 920.
- Solid and liquid material in the flow path possess inertia which prevents acceleration by the airstream towards the attachment outlet 920 resulting in separation of the solid and liquid material which drops out of the suspension into the base area 952 of the attachment body 950 or a collection container which may be coupled thereto.
- an inlet extension 912 protrudes into the attachment body 950.
- the inlet extension 912 may reduce risk of the attachment outlet 920 becoming occluded and/or may assist to direct solid and liquid material in the airstream into the attachment body base 952. Inlet extension 912 may also mitigate material being removed through the attachment outlet 920.
- a larger collection outlet 960 may be provided at the base of the attachment 900 for coupling with a collection device.
- a slot 942 may be provided for receiving a sealing member such as an O-ring, to ensure a sealing closure when a collection device is coupled with the collection outlet 960 of the attachment body 950.
- the collection device may comprise the apparatus 100.
- the attachment inlet 910 and attachment outlet 920 are provided on an attachment lid 930 which may be coupled with the attachment body 950 e.g.
- slot 940 may be provided for a sealing member such as an O-ring, between the attachment body 950 and attachment lid 930. It is to be understood, however, that the attachment body 950 and attachment lid 930 may be formed as a unitary piece when a collection outlet 960 is provided for a separable collection container.
- the attachment 900 be comprised of any suitable material such as medical grade polypropylene or polycarbonate. In use, it may be preferred to utilise the attachment 900 in a substantially vertical orientation, or in an orientation not greater than about 45 degrees to vertical, for collection of the material comprising the harvested tissue.
- the method 500 may comprise processing the harvested tissue 580 to homogenise the sample prior to separation of the cellular fraction (e.g., SVF). Processing may involve e.g.
- one of the syringes contains the harvested tissue and the other syringe may contain a saline solution to assist with processing. It is to be understood however that the process of harvesting the tissue may achieve some degree of tissue processing/homogenisation such that an additional processing step(s) may not be required.
- An example of processing harvested tissue is described in relation to method 700 as shown in Figures 12a and 12b.
- the cellular fraction (e.g., SVF) 582 is separated from the harvested tissue 580.
- the apparatus 100 comprising the collection vessel 110 and the filter barrel 120 containing the harvested tissue 580 within a centrifuge (not shown) where centrifugation occurs to separate a cellular fraction (e.g., SVF) 582.
- the apparatus containing the harvested tissue may be centrifuged for about 3 to about 8 minutes at about 1800 to 2700 g, such as for about 5 minutes at about 2000 g using a standard laboratory centrifuge.
- the collection vessel 110 may be configured to be received in a tube holder within the centrifuge.
- the collection vessel 110 may be configured to be received in a container such as a 50 mL centrifuge tube that is configured to be received in a tube holder the centrifuge.
- the cellular fraction (e.g., SVF) 582 is separated out from the harvested tissue 580 and sits atop the polymer composition 585 in the bottom part 114 of the collection vessel 110.
- the polymer composition 585 in the collection vessel 110 acts like a plug, owing to its solid (e.g., gel) state, preventing loss of the cellular fraction (e.g., SVF) 582 from the collection vessel opening 118.
- the collection vessel 110 is coupled e.g.
- the phase change mechanism is selected based on the polymer composition. Once liquified, the polymer composition 585 is able to be mixed with the cellular fraction (e.g., SVF) 582.
- the pre-loaded polymer composition 585 comprises gelatin methacryloyl (GelMA), and the phase change mechanism comprises heating the apparatus to a target temperature (typically 37 degC).
- the pre-loaded polymer composition comprises methacrylated alginate-RGD
- the phase change mechanism comprises addition of a solid to liquid phase change agent to the polymer composition, for example, a chemical agent (e.g., a chelator such as EDTA).
- the solid to liquid phase change agent may be introduced to the polymer composition via the delivery vessel 140 or via the top opening 116 in the collection vessel 110.
- the cellular fraction (e.g., SVF) 582 and polymer composition 585 are transferred from the collection vessel 110 to the delivery vessel 140.
- the delivery vessel 140 comprises a plunger 146 which may be retracted to draw fluid into the delivery vessel.
- the polymer composition 585 and the cellular fraction (e.g., SVF) 582 mix to form a cell loaded polymer composition 590 which is ready for delivery in step 560 to the defect site for repair or regeneration of the tissue or treatment of the defect. Delivery may be arthroscopically or by open surgery. [0168] Owing to its liquid state, the cell loaded polymer composition 590 fills the tissue defect area.
- the cell loaded polymer composition 590 is activated in a step 570 to initiate an irreversible phase change from liquid to solid for in situ stabilisation of the polymer composition, thereby forming a bioscaffold, such as a hydrogel bioscaffold, for cell proliferation and tissue growth.
- Activation may involve initiating crosslinking of the polymer composition e.g. photocrosslinking, by exposure to light as described in the examples below.
- the polymer composition 585 preloaded in the collection vessel 110 may be in a liquid state which is retained in the collection vessel by a closure, luer lock or by a valve closing the bottom opening 116 of the collection vessel, and operable by a user to control release of the contents of the collection vessel.
- a phase change mechanism is not required as disclosed in relation to step 540 which may simplify the process.
- the cell loaded polymer composition may be prepared within the collection vessel 110 e.g. by removal of the filter barrel containing the tissue fraction to be discarded following centrifugation, and introduction of a mixing member.
- the mixing member may comprise a plunger introduced into the collection vessel to advance the contents out through opening 118.
- the collection vessel 110 with a plunger may be used to deliver the cell loaded polymer composition directly to the defect site, or to a separate delivery device 140 coupled to the opening 118.
- the collection vessel 110 may be preloaded with a polymer composition that does not yet comprise a photoinitiator. This may be achieved by an additional step (not shown) of introducing a photoinitiator in the collection vessel before or after separation step 520.
- the photoinitiator may be introduced or preloaded in the delivery vessel 140, such step 550 forms the cell loaded polymer composition 590, comprising a mixture of the polymer composition 585 and the cellular fraction (e.g., SVF) 582, within the delivery vessel 140.
- Introducing the photoinitiator to the apparatus may avoid premature crosslinking of the polymer composition (e.g. due to exposure to light during transit and storage) thereby increasing shelf life.
- Figure 11 is a schematic representation of a method 600 for preparing a treatment composition comprising a cell loaded polymer composition according to another embodiment of the disclosure.
- apparatus 100 of Figures 1 to 2d is employed however it is to be understood that the apparatus of Figures 3 or 5a-e could be employed as alternatives.
- the apparatus is provided with the delivery vessel 140 preloaded with a volume of polymer composition 585 which is liquid at room temperature.
- harvested tissue 580 is provided into the filter barrel 120.
- the tissue may be harvested arthroscopically or upon open surgery from e.g. the infrapatellar fat pad (IFP). However it is to be understood that harvested tissue may be from other regions.
- the apparatus may be coupled with an attachment that provides for delivery of the harvested tissue from the arthroscope to the collection vessel 110 via a connected tubing system.
- the method 600 may comprise processing the harvested tissue 580 to homogenise the sample prior to separation of the cellular fraction (e.g., SVF) 582, as described in relation to method 500 shown in Figure 10 and the method 700 as shown in Figures 12a and 12b.
- the cellular fraction (e.g., SVF) 582 is separated from the harvested tissue 580. This may be achieved by placing the apparatus 100 comprising the collection vessel 110 and the filter barrel 120 containing the harvested tissue 580 within a centrifuge (not shown) where centrifugation occurs to separate a cellular fraction (e.g., SVF) 582.
- the apparatus containing the harvested tissue may be centrifuged for about 3 to about 8 minutes at about 1800 to 2200 g, such as for about 5 minutes at about 2000g using a standard laboratory centrifuge.
- the collection vessel 110 may be configured to be received in a tube holder within the centrifuge.
- the collection vessel 110 may be configured to be received in a such as a 50 mL centrifuge tube that is configured to be received in a tube holder within the centrifuge.
- the cellular fraction (e.g., SVF) 582 is separated out from the harvested tissue in the collection vessel 110.
- Figure 11 provides a valve connector 150 coupled with collection vessel 110 to prevent loss of the cellular fraction (e.g., SVF).
- a luer lock or other closure may be provided to prevent this loss.
- the collection vessel 110 is coupled via valve connector 150 with a delivery vessel 140.
- the delivery vessel 140 may be provided with a seal 142 over opening 144 to avoid loss of the preloaded polymer composition 585. Such a seal requires removal prior to coupling with valve connector 150.
- the valve connector 150 is opened by a user in step 640, permitting transfer of the cellular fraction (e.g., SVF) 582 into the delivery vessel 140.
- the delivery vessel 140 comprises a plunger 146 which may be retracted to transfer the liquid polymer composition into the delivery vessel. With retraction of the plunger 146 the liquid polymer composition can be mixed within the delivery vessel 140.
- the polymer composition 585 in the delivery vessel 140 and the cellular fraction (e.g., SVF) 582 from the collection vessel 110 mix to form a cell loaded polymer composition 590 ready for delivery in step 650 to the defect site for repair or regeneration of the tissue, or the treatment of the defect. Delivery may be arthroscopically or by open surgery. Delivery may be directly through the delivery vessel opening 144, or the contents may be transferred to a delivery device, such as a biopen. [0176] Owing to its liquid state, the cell loaded polymer composition 590 fills the tissue defect area.
- SVF cellular fraction
- the cell loaded polymer composition 590 is activated in a step 660 to initiate an irreversible phase change from liquid to solid for in situ stabilisation of the polymer composition, thereby forming a bioscaffold, such as a hydrogel bioscaffold, for cell proliferation and tissue growth.
- Activation may involve initiating crosslinking of the polymer e.g. photocrosslinking, by exposure to light as described in the examples below.
- the polymer composition 585 preloaded in the delivery vessel 140 is retained by a luer lock or valve connector (not shown) in lieu of removable seal 140.
- valve connector 150 may be provided with the collection vessel 110 which may instead be provided with a luer lock or removable seal to prevent loss of cellular fraction (e.g., SVF) 582 through opening 118.
- This arrangement may provide an advantage whereby the collection vessel is more easily accommodated within the centrifuge for separation of cellular fraction (e.g., SVF) 582 in step 620.
- valve connector 150 may be a 3-way connector providing an access port for introduction of other liquids.
- a 3 way connector may be used to introduce e.g. a photoinitiator (see below) or a solid to liquid phase change agent, for example, a chemical agent (e.g., a chelator such as EDTA) in examples such as Figure 10 where the preloaded polymer composition is in a solid (e.g., gel) state.
- the delivery vessel 140 may be preloaded with a polymer composition that does not yet comprise a photoinitiator. This may be achieved by an additional step (not shown) of introducing a photoinitiator in the delivery vessel 140 before delivery step 650, and preferably before step 640 in which the cellular fraction (e.g., SVF) is transferred into the delivery vessel so as to facilitate mixing of the photoinitiator together with the polymer composition and the cellular extract (e.g., SVF) 582.
- the cellular fraction e.g., SVF
- the photoinitiator may be introduced or preloaded in the collection vessel 110, and combined with the polymer composition when the cellular fraction (e.g., SVF) 582 and the photoinitiator are transferred to the delivery vessel 140 in step 640 thereby forming the cell loaded polymer composition 590.
- Introducing the photoinitiator within the apparatus may avoid degradation of the polymer composition (e.g. due to exposure to light during transit and storage) thereby increasing shelf life.
- Figures 12a and 12b are a schematic representation of a method 700 for preparing a cell loaded polymer composition 590 according to an embodiment of the disclosure.
- harvested tissue 580 is collected from a donor subject.
- the donor subject may be the patient being treated with the treatment composition, or a donor subject who is not the patient.
- the tissue may be harvested arthroscopically or upon open surgery from e.g. the infrapatellar fat pad (IFP).
- IFP infrapatellar fat pad
- IFP has been proven to be a good source for adipose derived stem cells e.g. mesenchymal stem cells for cartilage regeneration application.
- harvested tissue may be from other regions.
- the arthroscopy instrument may be coupled with an attachment 900 that provides for collection of the harvested tissue from the arthroscope to e.g. a collection device 980 via a connected tubing system 990.
- an attachment 900 is discussed with reference to Figures 9a-9c.
- the arthroscopy system provides suction and connection of the attachment 900 in the suction flow path permits collection of the harvested tissue into the attachment body 950 or a collection device 980 coupled with the attachment in a closed, sterile system.
- the amount of harvested tissue required for preparation of the treatment composition (e.g.6 mL) may be drawn into a transfer container 982 (e.g. a 10 mL syringe).
- a connector or coupling device may be used between the collection device 980 and transfer container 982.
- the method 700 may comprise step 720 for processing the harvested tissue 580 to homogenise and the sample prior to separation of the cellular fraction (e.g., SVF). Processing may involve e.g. transferring the harvested tissue between 2 containers connected via e.g. a luer lock system.
- the transfer container 982 contains the measured quantity harvested tissue and a first saline container 984 contains a sterile saline solution to assist with processing.
- the harvested tissue may be mixed with the sterile saline by transferring the contents between containers 982 and 984 e.g.
- a desired quantity (e.g.5 mL) of the processed harvested tissue 580a is transferred to the apparatus 100.
- a step 740 a cellular fraction (e.g., SVF) 582 is separated from the processed harvested tissue 580a. This may be achieved by placing the apparatus 100, comprising the collection vessel 110 and the filter barrel 120 containing the harvested tissue 580 coupled with collection container 160, within a centrifuge tube 170 and placing in centrifuge 742.
- Centrifugation occurs to separate a cellular fraction (e.g., SVF) 582 into the collection container 160.
- the apparatus containing the harvested tissue may be centrifuged for about 3 to about 8 minutes at about 1800 to 2700 g, such as for about 5 minutes at about 2500 g using e.g. a standard laboratory centrifuge.
- the cellular fraction (e.g., SVF) 582 is separated out from the harvested tissue 580 and is collected in collection container 160.
- the collection container 160 may be provided with a coupling at the opening that can be releasably coupled with a closure (not shown) for storing the sterile contents not used in the immediate procedure for preparing the treatment composition.
- the collection container 160 is coupled e.g. via a luer coupling with a mixing vessel 986 e.g. a sterile syringe of 1 mL capacity and a volume (such as about 0.05 mL) of the cellular fraction (e.g., SVF) 582 is drawn into the mixing vessel 986.
- a mixing vessel 986 e.g. a sterile syringe of 1 mL capacity and a volume (such as about 0.05 mL) of the cellular fraction (e.g., SVF) 582 is drawn into the mixing vessel 986.
- the cellular fraction in mixing vessel 986 may be mixed in a step 760 with a volume of sterile saline from a second sterile saline container 988, such as a syringe containing sterile saline.
- the quantity of saline mixed with the cellular fraction (e.g., SVF) 582 in mixing vessel 986 is about 0.45 mL.
- the mixing vessel 986 may be coupled with second sterile saline container 988 via a coupler which may have an elongated body and/or narrow bore to assist with mixing.
- An example is Aesthetic Group part no. FDO993922-R.
- the cellular fraction (e.g., SVF) 582 in mixing vessel 986 may be mixed with the sterile saline by transferring the contents between mixing vessel 986 and second sterile saline container 988 up to e.g.20 times, such as about 10 times or about 5 times, to achieve mixing of the cells with the saline.
- a quantity of the cell mixture 582a from step 760 is combined with the polymer composition 585.
- a required quantity of the polymer composition 585 is preloaded in a polymer container 989 such as a 1 mL syringe which is capped to prevent leakage of the liquid polymer composition.
- a required quantity of the polymer composition 585 may be drawn up from polymer container 989 into a syringe that is not preloaded.
- a desired quantity of the cell mixture 582a (e.g.0.25 mL) may be drawn into polymer container 989 to form the cell loaded polymer composition 590.
- a blending vessel 987 may be used in a step 780 to combine the cell mixture 582a with the polymer composition 585 by transferring the contents between polymer container 989 and blending vessel 987 up to e.g.60 times, such as about 50 times or about 40 times or about 30 times, or fewer as may be the case, to achieve mixing of the cell mixture 582a with the polymer composition 585.
- a connector 985 which may have an elongated body and/or narrow bore may be coupled between polymer container 989 and blending vessel 987 to assist with mixing to produce the cell loaded polymer composition 585.
- the blending vessel 987 may comprise a 1 mL syringe and in some examples, may perform the function of the delivery vessel 140.
- the contents of the blending vessel 987 delivery vessel 140 comprising the cell loaded polymer composition 590 may be transferred to a delivery device, such as a biopen 1730 which is ready for delivery in step 795 to the defect site for repair or regeneration of the tissue or treatment of the defect.
- a delivery device such as a biopen 1730 which is ready for delivery in step 795 to the defect site for repair or regeneration of the tissue or treatment of the defect.
- the polymer composition may be a liquid with photoinitiator included. Delivery may be arthroscopically or by open surgery. Owing to its liquid state, the cell loaded polymer composition 590 fills the tissue defect area.
- the cell loaded polymer composition 590 is activated to initiate an irreversible phase change from liquid to solid for in situ stabilisation of the polymer composition, thereby forming a bioscaffold, such as a hydrogel bioscaffold, for cell proliferation and tissue in growth.
- Activation may involve initiating crosslinking of the polymer composition e.g. photocrosslinking, by exposure to light such as light having a wavelength of about 405 nm, optionally at about 20 mW/cm 2 for about 60 seconds to about 180 seconds, such as for about 120 seconds.
- polymer container 989 may be preloaded with a polymer composition which is in a solid/gel state to mixing with the cell mixture.
- a phase change step may be introduced prior to step 770 to change the state of the polymer composition 585 from solid to liquid form of lower viscosity allowing it to be mixed with the cell mixture 582a.
- the phase change mechanism may be selected based on the polymer composition.
- the pre-loaded polymer composition 585 comprises gelatin methacryloyl (GelMA), and the phase change mechanism comprises heating the apparatus to a target temperature (typically 37 degC). This may be achieved by placing the polymer container 989 in an incubator, such as a standard laboratory incubator, to warm the contents.
- the pre-loaded polymer composition comprises methacrylated alginate-RGD
- the phase change mechanism comprises addition of a solid to liquid phase change agent to the polymer composition, for example, a chemical agent (e.g., a chelator such as EDTA). It may be preferred, however that the polymer composition is provided in liquid phase to reduce the number of steps required to prepare the cell loaded polymer composition.
- the polymer container 989 may be preloaded with a polymer composition that does not yet comprise a photoinitiator. Preparation of the polymer composition comprising the photoinitiator may be achieved by an additional step (not shown) of introducing a photoinitiator in the polymer container 989 prior to blending step 790. Alternatively or additionally, the photoinitiator may be introduced or preloaded in the blending vessel 987, such that step 790 forms the cell loaded polymer composition 590, comprising a mixture of the polymer composition 585 and the cell mixture 582a together with the photoinitiator. Introducing the photoinitiator to the apparatus may avoid premature crosslinking of the polymer composition (e.g.
- kits that contain many or all of the consumable components required for a particular procedure, and their assembly or utilisation can follow an orderly sequence to enhance the efficiency, effectiveness and safety of the procedure.
- kits may also contain re-usable components that can be sterilised and re-used in kits prepared for further 13 to 16 are schematic illustrations of kits for preparation of a treatment composition for treatment or repair of damaged tissue according to embodiments of the disclosure.
- the kits are required to be sterile when they reach the surgical environment and are typically, therefore, manufactured as sterile sealed kits.
- FIG. 13 shows a kit 1700 comprising an apparatus having a collection vessel 110 preloaded with a polymer composition 585 consistent with the example shown in Figure 10.
- the filter element may comprise a filter barrel 120 with a strainer as shown, or it may comprise a strainer 112 attached to or formed integrally with an interior wall of the collection vessel 110 as in Figure 3.
- kit 1700 may be one or more of a delivery vessel 140, a light source 1710, a solid to liquid phase change mechanism or agent 1720 and a delivery device 1730.
- An attachment 900 for collecting the harvested tissue may also be provided.
- FIG 14 shows a kit 800 comprising an apparatus 100 having a collection vessel 110, and a delivery vessel 140 preloaded with a polymer composition 585 consistent with the example shown in Figure 11.
- the filter element may comprise a filter barrel 120 with a strainer 112, or it may comprise a strainer 112 attached to or formed integrally with an interior wall of the collection vessel 110 as in Figure 3.
- Also provided within kit 800 may be one or more of a light source 1710 and a delivery device 1730.
- An attachment 900 for collecting the harvested tissue may also be provided.
- kits Components of the kit are provided in a sterile housing 1740 with a removable sterile seal (not shown).
- provision of the collection vessel preloaded with the polymer composition reduces the number of preparation or assembly steps required during the procedure.
- the kit housing 1740 and seal are photoopaque so as to reduce risk of premature crosslinking.
- the element containing the photoinitiator may be provided in photoopaque packaging within the kit to risk of degradation.
- Figure 15 shows a kit 1900 comprising an apparatus having a collection vessel 110 and a container 989 of polymer composition 585 with a separate container 584 of photoinitiator for preparation of the polymer composition within the apparatus.
- One or more measuring devices may be provided to measure a required amount of the polymer composition to load into the collection vessel 110.
- a delivery vessel 140, light source 1710 and a delivery device 1730 may be provided within the kit 1900.
- a solid to liquid phase change mechanism or agent 1720 may also be provided if the polymer is in a solid material state when the kit is sealed.
- An attachment 900 for collecting the harvested tissue may also be provided.
- Components of the kit are provided in a sterile housing 1740 with a removable sterile seal (not shown).
- the kit housing 1740 and seal are photoopaque so as to reduce risk of premature crosslinking, and/or that the element containing the photoinitiator may be provided in photoopaque packaging within the kit.
- the polymer composition 585 and/or the photoinitiator 584 may be provided separately from the kit 1900. This may further extend the shelf life of the kit and avoid stringent storage conditions that may require light and temperature control in order to limit degradation and/or premature crosslinking of the polymer composition 585 and/or the photoinitiator 584. A centrifuge is necessary but need not be provided within the kit.
- Figure 16 shows a kit 1600 comprising items used for preparation of a treatment composition according to embodiments of the present disclosure consistent with the example described with reference to Figures 12a and 12b.
- the kit 1600 may comprise further kits which may be individually and sterilely sealed within the kit 1600. These are referred to as kit components and are shown in dot-dash lines.
- the kit components may be marked with a number or name which designates the order in which the package should be opened into a sterile area for use in the preparation of the treatment composition.
- the various kit items may be provided in a single sealed package.
- the kits represented by kit components may be supplied as individual sealed packages that are supplied separately but may be indicated for use together as disclosed herein.
- One kit component may comprise a tissue collection kit 1610 comprising medical grade tubing 990, arthroscope attachment 900 and collection device 980. Coupling components for assembly of the parts of tissue collection kit 1610 may also be provided, as may transfer container 982 which may be used to draw up a desired quantity of harvested tissue, and/or a first saline container 984 the contents of which may be used to process the harvested tissue by mixing with sterile saline, such as 0.9% medical grade saline.
- first saline container 984 comprises a pre-filled syringe.
- kits 1620 comprising an apparatus 100 having a collection vessel 110, a filter barrel 120 comprising a strainer 121, a spacer 123, collection container 160, coupler 165 and optional stopper 130 although other apparatus configurations may be provided such as those described with reference to Figures 1 to 4e.
- a removable closure for the collection container 160 may also be provided in some cases where preservation of the cellular fraction (e.g. SVF) may be desirable.
- These components may be provided in the kit 1600/kit component 1620 in an assembled or unassembled form.
- a centrifuge tube 170 and open cap 175 may also be provided as part of the kit 1600, apparatus kit 1620, or as part of a centrifuge kit 1620a.
- Another kit component may comprise polymer kit 1630 comprising a polymer container 989, such as a syringe which is prefilled with a quantity of the polymer composition.
- the kit component 1630 may comprise a radio-opaque sealed bag or container to avoid or at least limit degradation prior to use.
- the preloaded polymer is a liquid
- the polymer container 989 may be closed with a removable stopper or seal 979 to prevent leakage in the package.
- a seal may not be required. It may be desirable for the polymer composition provided in the kit 1600/ kit component 1630 to comprise a photoinitiator however that need not be the case and the kit 1600 or kit component 1630 may comprise a separate photoinitiator which may be mixed with the polymer composition prior to delivery of the cell-loaded polymer composition to the treatment site.
- Kit 1600 or one or both of apparatus kit 1620 and polymer kit 1630 may comprise one or more blending vessels 987 and/or second sterile saline containers 988 containing saline, for preparation of a cell mixture or blending the cell loaded polymer composition as described with reference to the methods disclosed herein.
- the blending vessel 987 may comprise a syringe and in some examples, may perform the function of the delivery vessel 140 for providing the cell loaded polymer composition to a delivery device such as a biopen.
- the second sterile saline container 988 may comprise a pre-filled syringe.
- kits 1640 comprising an extrusion tip 983.
- the kit 1600/delivery kit 1640 may also comprise a delivery device such as e.g. biopen 1730.
- kit 1600/ delivery kit 1640 may comprise a light source 1730.
- the light source may be provided separately from the delivery device, or it may be e.g. integrated into the biopen.
- the kit 1600/delivery kit 1640 comprises protective eyewear 977 for use by the clinician during photoactivation of the treatment composition after delivery to the treatment site.
- Components of the kit 1600 are provided in a sterile housing 1740 with a removable sterile seal (not shown), as may be the kit components. A centrifuge is necessary but need not be provided within the kit.
- provision of the apparatus in a pre- assembled form and/or provision of the polymer preloaded in the polymer container 989 reduces the number of preparation or assembly steps required during the procedure.
- the kit housing 1740 and seal are photo opaque so as to reduce risk of premature crosslinking.
- the element containing the photoinitiator may be provided in photo opaque packaging within the kit to reduce risk of [0202]
- the following examples further illustrate aspects of the disclosure with respect to specific functional polymers.
- the collection vessel 110 was preloaded with polymer composition comprising 300 ⁇ l of GelMA 20% (Type A gelatin obtained from porcine skin, bloom 300, with about 84% methacryloyl functionalisation) with 0.2% Lithium phenyl-2,4,6 trimethylbenzoylphosphinate (LAP) (a solid/gel at room temperature).
- LAP Lithium phenyl-2,4,6 trimethylbenzoylphosphinate
- the collection vessel was coupled with a delivery vessel comprising a 1 mL low dead volume syringe and mounted vertically on a stage inside a 37 °C – incubator to induce a solid to liquid phase change of the polymer composition.
- the SVF and the polymer composition were collected into the delivery vessel 140 by drawing out a plunger from the delivery vessel to draw in and mix the fluid from the collection vessel to form the cell loaded polymer composition.
- Approx.400-600 ul of cell loaded polymer composition was collected in the delivery vessel.
- the resulting cell loaded polymer composition was: GelMA 10% and Lithium phenyl-2,4,6 trimethylbenzoylphosphinate (LAP) 0.1% containing SVF.
- LAP Lithium phenyl-2,4,6 trimethylbenzoylphosphinate
- the cell loaded polymer composition was delivered in vivo with open knee surgery in a rabbit animal model. Solidification of the cell loaded polymer composition was achieved via photocrosslinking with light using 405 nm light source at 20 mW/cm 2 for 1 minute. Samples were collected from the after 1 month from the day of treatment, where the treatment involved one of: (1) injection of native cartilage (“Cartilage”); (2) a 4 mm diameter cartilage lesion generated with a biopsy punch, that was left untreated (“Empty”); or (3) treated with the cellular fraction product mixed with a biomaterial, obtained with the apparatus (“SVF”).8 rabbits were treated with the cell loaded polymer composition, while 4 rabbits were used for each of the Cartilage and Empty treatment groups.
- Example 2 Preparation of cartilage repair treatment using methacrylated alginate-RGD [0207] IFP tissue was retrieved and underwent mechanical processing and was transferred into filter barrel 120 as in Example 1.
- the delivery vessel 140 was preloaded with polymer composition comprising 400 ⁇ l of 5% methacrylated alginate-RGD (270 kDa alginate with M/G ratio of approximately 1.3, about 45-46% methacrylate functionalisation and 5-6% RGD, as a wt% substitution of reactive groups) and LAP 0.125%.
- the collection vessel 110 with filter barrel containing the IFP tissue was placed in a centrifuge and centrifugation took place at 2000 g for 5 minutes to purify the cellular fraction. Approx.100 ul of cellular fraction was collected in the collection vessel 110.
- the collection vessel was coupled via valve connector that is opened by a user, permitting transfer of the cellular fraction into the delivery vessel.
- the SVF and the polymer composition were mixed within the delivery vessel 140 by drawing out a plunger from the vessel to draw in and mix the components to form the cell loaded polymer composition. Approx.400-600ul of cell loaded polymer composition was collected in the delivery vessel. The resulting cell loaded polymer composition was: 4% methacrylated alginate-RGD and Lithium phenyl-2,4,6 trimethylbenzoylphosphinate (LAP) 0.1% containing cellular fraction (i.e., SVF). The cell loaded polymer composition was delivered in PDMS moulds. Solidification of the cell loaded polymer composition was achieved via photocrosslinking with light using 405 nm light source at 20 mW/cm 2 for 1 minute.
- LAP Lithium phenyl-2,4,6 trimethylbenzoylphosphinate
- LAP Lithium phenyl-2,4,6 trimethylbenzoylphosphinate
- the mean tissue mass was 0.242 g (median value of 0.163 g) and mean fibroblast growth factor-2 (FGF-2) concentration of 9.051 ng/mL (median value of 8.637 ng/mL) (Figure 19).
- the cell loaded polymer composition treatment showed a significant increase in metabolic activity of the cells when used between 1% and 5%.
- Example 4 IFP retrieval and cartilage repair treatment in sheep model
- Cartilage repair was performed on 12 Merino sheep that received a full cartilage femoral defect of 6 mm diameter size, according to the method 700 outlined in Figures 12a and 12b and detailed further in this Example using the kit comprising at least the components of Figure 16, as outlined in Table 1.
- the present method uses an arthroscope coupled with an attachment 900, an arthroscope shaver 5 mm full radius (sterile, individually , centrifuge (non-swing rotor with 50 mL centrifuge tube buckets), sunglasses for light exposure, 2x 10 mL vials with 0.9% Medical Grade Saline, extrusion tip, and Biopen.
- Table 1 components of the kit used in the method of Example 4 Component number Component Contents 1 Collection device ⁇ 20 mL syringe (plunger removed) 0 [0210] Sheep were anaesthetised and placed in a sternal or dorsal recumbency position. A 4 cm mini arthrotomy was performed on hind legs, involving a capsular incision and dislodging of the patellar to expose the infrapatellar fat pad (IFP). The IFP was removed from each leg, combined, and minced using the arthroscope with 5.5 mm full radius blade using the Oscillator function. The minced IFP is collected in the collection device 980, after which the arthroscope attachment was removed and discarded.
- IFP infrapatellar fat pad
- the cap was then then removed from the bottom of the collection device 980, in order to connect it to the transfer container 982.5 mL of fat was then drawn into the transfer container 982, before removing and discarding the collection device .
- the transfer container 982 was then connected to the saline container 984, containing 1.25 mL of saline solution, and the saline and minced IFP were mixed between the two containers 5 times back and forth.
- the mixed fat/saline solution was located in the saline container 984, and the transfer container 982 was removed and discarded.5 mL of the fat/saline solution was then loaded into the open end of the apparatus 100, after which the open end of the apparatus 100 was closed was a black rubber seal 130 (dome first), and the saline container 984 discarded.
- the apparatus 100 was placed into the centrifuge tube 170, and the combined device was centrifuged at 2500 g for 5 minutes.
- the chondral defect procedure was carried out to create a 6 mm biopsy punch on a weight bearing region of the condyle from both hind legs of the sheep.
- the cartilage layer was removed to create a chondral defect, without opening the subchondral bone.
- the surgeon was then informed which leg (Left or Right) was to act as a control “Empty” defect, and which will have the cell loaded polymer composition applied.
- the apparatus 100 was removed from the centrifuge tube 170, and the collection container 160, containing the cellular fraction 582, was detached from the apparatus 100.
- the mixing vessel 986 was used to draw up 50 ul of the composition from the collection container 160 which was then attached to the second sterile saline container 988, containing 0.450 mL of saline solution, and the two products mixed by mixing the syringes back and forth 5 times. After the final mix, the cell mixture was located in the mixing vessel 986, and the saline container 988 was removed and discarded. The polymer container 989 was then connected to the mixing vessel 986 and 250 ul of solution transferred to the polymer 989. The blending vessel 987 was then connected to the polymer container 989 and the contents gently mixed between the two syringes 40 times.
- the mixed solution was located in the polymer container 989, the blending vessel 987 was removed and discarded, and the extrusion tip 983 was attached to the polymer container 989.
- the polymer container 989 was then attached to the Biopen 1730, and the chondral lesion was filled with the cell loaded polymer composition, so that the composition was level with the outer cartilage.
- the Light Adaptor 1710 was then connected to the Biopen, and the light adaptor placed over the filled chondral defect. The curing light was turned on and 405 nm light source was applied to the filled chondral defect at 20 mW/cm 2 for 2 minutes.
- cartilage harvested from the IFP tissue harvested from other sites, particularly those tissues with cells having high chondrogenic capacity, may be suitable for use with embodiments of the novel apparatus, kits and method disclosed herein to prepare compositions for repair or regeneration of tissue, or treatment of defects in cartilage and other tissues.
- chondrogenic potential in the context of a cell means that the cell has the capacity to promote cartilage growth, particularly hyaline cartilage. This term is applied to cells which stimulate cartilage growth, such as chondrocytes, and to cells which themselves have the capacity to differentiate into a chondrocyte under appropriate conditions.
- Hyaline cartilage exists on the ends of ribs, in the larynx, trachea, and bronchi, and on the articulating surfaces of bones.
- harvested tissue containing cells with osteogenic and/or adipogenic potential could be used with the apparatus, kits and methods disclosed herein in the preparation of a treatment composition for the repair or regeneration of tissue, or the treatment of bone defects, osteochondral defects, cartilage defects (not only articular cartilage), or adipose tissue repair (e.g. breast reconstruction).
- the mesenchymal stem cells, or related precursors, or cells derived from these cells have the capacity to form molecules of the extracellular matrix, and in particular molecules required for chondrogenesis and cartilage repair and restoration.
- Adipose derived stem cells are particularly useful where the method is to be utilised in a procedure for cartilage repair or restoration.
- ADSCs may obtained from a number of different fatty tissues of the human or animal body.
- the ADSCs may be autologous or allogeneic.
- Advantages [0219] utilises a tissue engineering approach to cartilage repair and regeneration based on highly chondrogenic stem cells in the cellular fraction (i.e., the SVF) from the IFP.
- the disclosure enables promotion and/or repair or regeneration of tissue such as cartilage tissue using these stem cells which may be harvested, treated and administered to the patient to achieve tissue repair, in a single sterile environment.
- the harvested tissue is autologous however it is contemplated that the harvested tissue may originate from a donor source, which may be harvested in a common sterile space to the patient receiving the therapy to minimise procedure duration and risk of contamination.
- the novel apparatus enables the procedure to be streamlined to be achievable in a single surgical operation in an acceptable timeframe without requiring any of the patient’s cells/tissues to leave the surgical theatre and without the usage of any animal derived processing enzymes.
- Embodiments of the present disclosure may achieve repair or regeneration of tissue such as cartilage without the requirement to introduce additional microlesions in the bone as in the microfracture method. Furthermore, it does not require removal of healthy cartilage from a different region of the joint as in the mosaicplasty method.
- Embodiments of the present disclosure may achieve repair or regeneration of tissue in a single surgical procedure in a single sterile environment, and does not require isolation and expansion of cells from the donor site before the as in the ACI and MACI techniques.
- the treatment composition of the present disclosure may be tailored for cartilage repair or regeneration due to use of a particular type of fat, already present in the knee joint, that contains cells with high chondrogenic capacity.
- the functionalisation of the polymer to achieve in situ stabilisation of the polymer composition fixes the cell loaded polymer composition in the defect.
- lipogems use only subabdominal tissue and require additional microperforation of the lesion.
- Cell loaded polymer compositions prepared according to embodiments of the disclosure may contain immunomodulatory factors and also chondrogenic cells and so can enhance localised action at the repair site, representing an advantage over other repair methodologies that are deprived of any cellular component.
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Abstract
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Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| EP24813617.8A EP4719514A1 (en) | 2023-05-31 | 2024-05-31 | Apparatus for use in tissue repair |
| AU2024278705A AU2024278705A1 (en) | 2023-05-31 | 2024-05-31 | Apparatus for use in tissue repair |
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| AU2023901716A AU2023901716A0 (en) | 2023-05-31 | Apparatus for use in tissue repair | |
| AU2023901716 | 2023-05-31 |
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| WO2024243646A1 true WO2024243646A1 (en) | 2024-12-05 |
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| PCT/AU2024/050581 Ceased WO2024243646A1 (en) | 2023-05-31 | 2024-05-31 | Apparatus for use in tissue repair |
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| EP (1) | EP4719514A1 (en) |
| AU (1) | AU2024278705A1 (en) |
| WO (1) | WO2024243646A1 (en) |
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| WO2013003229A1 (en) * | 2011-06-28 | 2013-01-03 | Veris Medical, Inc. | System and method for collagen isolation |
| WO2014110448A1 (en) * | 2013-01-11 | 2014-07-17 | The Gid Group, Inc. | Method for processing cancellous bone material and related products, methods and uses |
| US20170368226A1 (en) * | 2016-05-13 | 2017-12-28 | Black Tie Medical Inc. dba Tulip Medical Products | Conditioning Harvested Fat for Re-Injection |
| KR20190041658A (en) * | 2017-10-13 | 2019-04-23 | (주) 레보메드 | Fat SVF(stromal vascular fraction) extracting apparatus and fat SVF(stromal vascular fraction) extracting method using the same |
| US10639046B2 (en) * | 2018-01-26 | 2020-05-05 | Smith & Nephew, Inc. | Tissue collection and delivery device and methods of use thereof |
| US20210038762A1 (en) * | 2018-01-31 | 2021-02-11 | Rokit Healthcare Inc. | Bioink composition for cartilage regeneration, method for manufacturing customized scaffold for cartilage regeneration using same, and customized scaffold for cartilage regeneration manufactured using manufacturing method |
| WO2022133201A1 (en) * | 2020-12-18 | 2022-06-23 | Drexel University | Injectable, cross-linkable and subcellular size microfibers for soft tissue repair |
-
2024
- 2024-05-31 WO PCT/AU2024/050581 patent/WO2024243646A1/en not_active Ceased
- 2024-05-31 EP EP24813617.8A patent/EP4719514A1/en active Pending
- 2024-05-31 AU AU2024278705A patent/AU2024278705A1/en active Pending
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| WO2013003229A1 (en) * | 2011-06-28 | 2013-01-03 | Veris Medical, Inc. | System and method for collagen isolation |
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| US10639046B2 (en) * | 2018-01-26 | 2020-05-05 | Smith & Nephew, Inc. | Tissue collection and delivery device and methods of use thereof |
| US20210038762A1 (en) * | 2018-01-31 | 2021-02-11 | Rokit Healthcare Inc. | Bioink composition for cartilage regeneration, method for manufacturing customized scaffold for cartilage regeneration using same, and customized scaffold for cartilage regeneration manufactured using manufacturing method |
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| LI SHIYI, SUN JIACHEN, YANG JINXIU, YANG YI, DING HONGFAN, YU BOYA, MA KUI, CHEN MINLIANG: "Gelatin methacryloyl (GelMA) loaded with concentrated hypoxic pretreated adipose-derived mesenchymal stem cells(ADSCs) conditioned medium promotes wound healing and vascular regeneration in aged skin", BIOMATERIALS RESEARCH, BIOMED CENTRAL LTD, LONDON, UK, vol. 27, no. 1, 9 February 2023 (2023-02-09), London, UK , XP093249759, ISSN: 2055-7124, DOI: 10.1186/s40824-023-00352-3 * |
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| Publication number | Publication date |
|---|---|
| AU2024278705A1 (en) | 2025-12-11 |
| EP4719514A1 (en) | 2026-04-08 |
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